{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:20:28Z","timestamp":1775146828019,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K01DA055130"],"award-info":[{"award-number":["K01DA055130"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["UG1DA015831"],"award-info":[{"award-number":["UG1DA015831"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to estimate how ongoing stimulant use affects return to illicit opioid use after initiation onto medication for opioid use disorder (MOUD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a secondary analysis of pooled data from two clinical trials comparing buprenorphine (BUP\u2010NX) and extended\u2010release naltrexone (XR\u2010NTX).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Thirteen opioid treatment programs and HIV clinics across 10 states in the United States from 2014 to 2019 took part in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A total of 528 participants who initiated MOUD as part of trial participation were included. Nearly half (49%) were between 30 and 49\u2009years of age, 69% were male and 66% were non\u2010Hispanic White.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome was first self\u2010reported day of non\u2010prescribed opioid use following MOUD initiation, and the exposure of interest was daily stimulant use (methamphetamine, amphetamines or cocaine). Both were defined using time\u2010line follow\u2010back. Among participants reporting at least 1\u00a0day of illicit opioid use, we also examined relapse to ongoing use, defined as (1) 7\u00a0days of continuous opioid use or (2) 4 consecutive weeks with self\u2010reported opioid use, one or more positive urine drug screens (UDS) for opioids or one or more missing UDS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Forty\u2010seven per cent of participants reported stimulant use following MOUD initiation, 58% returned to illicit opioid use and 66% of those relapsed to ongoing use. Stimulant use was strongly associated with increased risk of misusing opioids after MOUD initiation when measured daily [adjusted hazard ratio (aHR)\u2009=\u20099.23, 95% confidence interval (CI)\u2009=\u20096.80\u201312.50, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001] and over a 7\u2010day period (aHR\u2009=\u20091.27 for each additional day, CI\u2009=\u20091.18\u20131.37, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Using stimulants weekly or more often was associated with increased likelihood of relapse to ongoing opioid use compared with less than weekly or no stimulant use (adjusted odds ratio\u2009=\u20092.30, CI\u2009=\u20091.05\u20135.39, <jats:italic>P<\/jats:italic>\u2009=\u20090.044).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>People initiated on medication for opioid use disorder who subsequently use stimulants appear to be more likely to return to and continue using non\u2010prescribed opioids compared with those without stimulant use. The association appears to be stronger among patients who initiate buprenorphine compared with those who initiate extended\u2010release naltrexone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16334","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T08:01:54Z","timestamp":1694764914000},"page":"149-157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder"],"prefix":"10.1111","volume":"119","author":[{"given":"Canyon","family":"Foot","sequence":"first","affiliation":[{"name":"Department of Medicine, Section of Addiction Medicine Oregon Health and Science University  Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5556-3597","authenticated-orcid":false,"given":"Philip T.","family":"Korthuis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Addiction Medicine Oregon Health and Science University  Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-5399","authenticated-orcid":false,"given":"Judith I.","family":"Tsui","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Washington  Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean X.","family":"Luo","sequence":"additional","affiliation":[{"name":"Division on Substance Use Disorders, Department of Psychiatry Columbia University  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Addiction Medicine Oregon Health and Science University  Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8754-995X","authenticated-orcid":false,"given":"Ryan R.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Addiction Medicine Oregon Health and Science University  Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2016.1271432"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.08.029"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2020.106752"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2019.305412"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.10.011"},{"key":"e_1_2_10_7_1","unstructured":"AhmadFB RossenLM SuttonP.Provisional drug overdose death counts for 12 months ending November 2021 updated April 2022: National Center for Health Statistics2022. 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